Depressive Neurosis: Symptoms, Causes and Treatment

Table of Contents

Last Updated on April 13, 2023 by Mike Robinson

Depressive neurosis is a psychopathological disorder characterized by the presence of a constant state of sadness. Experts consider it to be a mild but permanent case of depression.

People who have this disorder have sad moods for long periods. Likewise, they are physically inactive and sedentary for extended periods.

What is it?

Depressive neurosis frequently comes with bodily changes and sleep issues as well. Although the affected individuals can still function to some extent, their poor mental health leaves them in intense pain and severely impairs their quality of life.

Depressive neurosis is not currently a recognized diagnosis. The condition known as dysthymia has supplanted it in diagnostic guides. However, depressive neurosis contributed essential knowledge about depressive psychopathologies and laid the groundwork for mood disorders.

Let’s review the symptoms, diagnosis, and causes of depressive neurosis, along with the possible interventions available to treat it.

Characteristics of depressive neurosis.

Depressive neurosis is a mood disorder that is defined by seven stable and significant characteristics:

severe mood alterations
causes prolonged psychopathology.
It has a cerebral representation.
The symptoms occur periodically
has a probable genetic link.
Higher risk for specific personality traits
It allows for integral biopsychosocial restitution.

A diagnosis of depressive neurosis has the following criteria that define the patient’s condition:

A depressive mood most of the day, most days, for not less than two years.
Cannot go more than two months free of symptoms and without major mood disorder or mania.

Depressive neurosis has two main differences from major depression.

First, depressive symptoms are milder and do not reach the typical intensity of major depression.
Secondly, the evolution and prognosis of depressive neurosis are more chronic and stable than those of depression.

Signs and symptoms

The triad of typical symptoms characterizes depressive neurosis: decreased vitality, depressed mood, and slowed thinking and speech.

These three manifestations are the most important of the disorder and occur in all cases. However, the symptomatology of this neurosis is much more extensive.

Thus, this disorder may have different emotional, cognitive, and behavioral symptoms. The most prevalent are:

Loss of interest in daily activities
feelings of sadness.
Despair.
Lack of energy.
Fatigue or lack of energy
Low self-esteem.
Difficulty concentrating.
Difficulty in making decisions.
Self-criticism
Excessive anger
decreases productivity
Avoidance of social activities
feelings of guilt.
Lack or excess appetite
Problems sleeping

Depressive neurosis in children may be slightly different. In these cases, apart from the manifestations above, other symptoms are usually present, such as:

Generalized irritability throughout the day.
Low school performance and isolation
Pessimistic attitude
Lack of social skills and little relational activity

Clinical Studies

mood swings — Mood swings include sadness and aggravation

Depressive neurosis causes a terrible mood and a feeling of weakness all over the body. Other physical signs often occur; these are typical symptoms of psychopathy. Most people experience dizziness, palpitations, changes in blood pressure, loss of appetite, and problems with how the GI tract works.

The subject’s mood deteriorates, and the sadness in their life becomes more pronounced over time. Due to this, one loses interest and finds it challenging to experience positive emotions and pleasant sensations. Other symptoms of depressive neurosis, like decreased motor activity, poor facial expression, slow thinking, and unusually slow speech, can occasionally be present.

These symptoms typically have an impact on the person’s daily life. Depressive neurosis patients frequently persist in “pulling,” though. They can continue working even if it costs them a lot to focus, perform well, maintain healthy relationships, and have a healthy family environment.

However, the subject never feels satisfied after engaging in these activities. He never acts out of the desire to do so; instead, he always acts out of duty or obligation. On the other hand, sleep problems are a common symptom of depressive neurosis. The most frequent is having a hard time falling asleep and waking up during the night. These changes could also include heart palpitations or other anxiety-related symptoms.

Causes of depressive neurosis according to psychoanalytic analysis

According to the psychoanalytic currents, which were those who coined the term “depressive neurosis disorder,” this psychopathology is the result of an existing psychogenic condition.

Therefore, the development of this neurosis is related to traumatic circumstances or unpleasant external experiences.

Psychoanalytic theories suggest that the external factors that can cause depressive neurosis are significant for the subject.

In reference to stress situations that lead to depressive neurosis, two main groups are identified.

The first one is related to the performance of the person. Numerous personal failures in different areas of the subject’s life lead to an interpretation of “I am a complete failure.”

The so-called facts of emotional deprivation form the second group. In this case, when the individual is forced to separate from his loved ones and cannot cope, they can develop this neurosis.

Etiological factors

Current research on this disorder has put aside psychoanalytic theories and focused on studying other factors.

In this sense, no element has been detected as the cause of the pathology. However, certain factors that could be related have been mentioned.

In general, these can be biological factors, genetic factors, and environmental factors.

Biological factors

The psychopathology referring to depressive neurosis is very heterogeneous, making its investigation difficult. However, certain studies show that the disorder could be explained through neurophysiological, hormonal, and biochemical aspects.

a) Neurophysiology

The neurophysiological findings in depressive neuroses have been one of the most important aspects of their diagnosis.

One of the most studied elements is related to REM latency. Thus, people with depressive neurosis seem to have significantly lower REM sleep latency than the rest of the population.

b) Hormonal studies

Within the neuroendocrine tests, the dexamethasone suppression test has been one of the most studied in depressive neurosis.

In general, the results obtained show that subjects with this neurosis have a relatively lower percentage of “non-suppressors” than people with major depression.

c) Biochemistry

Finally, as regards biochemistry, several studies show that depressive neurosis could be related to serotonin receptors.

In this sense, it is postulated that individuals with this neurosis could have fewer receptors for this substance. However, some studies have corroborated these findings and rejected others.

Genetic factors

Alterations in mood appear to have important genetic components in their etiology. In this sense, people with a history of depression in their family may be more susceptible to developing depressive neurosis.

Environmental factors

Finally, this last group of factors has to do with life situations that are complex for people to face.

They are remarkably related to the concepts postulated by psychoanalysis and could play an essential role in the development of pathology.

Diagnosis

At present, the diagnosis of depressive neurosis has been evicted. This means that the term “neurosis” is no longer used to detect this mood change; however, it does not mean that the disorder does not exist.

Instead, depressive neurosis has been reformulated and renamed persistent depressive disorder, or dysthymia. There are many similarities between both pathologies, so they can be considered equivalent disorders.

In other words, the subjects who, years ago, received a positive diagnosis of depressive neurosis currently have dysthymia instead.

The symptoms are practically identical and refer to the same psychological disorder. The criteria established for the diagnosis of persistent depressive disorder (dysthymia) are:

Derepressed during most of the day, present more days than those absent, as shown by subjective information or observation by others, for a minimum of two years.

The presence, during depression, of two (or more) of the following symptoms:

- littLittleetite or overfeeding.
- Insomnia or hypersomnia
- little energy or fatigue
- low self-esteem.
- lack of concentration or difficulty making decisions
- Feelings of hopelessness

During the two-year period (one year in children and adolescents) of the alteration, the individual has never been without the symptoms of Criteria 1 and 2 for more than two months in a row.

The criteria for a major depressive disorder can be continuously present for two years.

There has never been a manic or hypomanic episode, and the criteria for cyclothymic disorder have never been met.

The disturbance is not better explained by a persistent schizoaffective disorder, schizophrenia, delusional disorder, or other specified or unspecified disorder on the spectrum of schizophrenia and other psychotic disorders.

The symptoms can not be the result of the physiological effects of a substance (eg, a drug, a medication) or another medical condition (e.g., hypothyroidism).

Symptoms cause clinically significant discomfort or deterioration in social, occupational, or other important areas of functioning.

Treatment

The current treatment of depressive neurosis is complex and controversial. The subjects with this alteration usually require medication, although it is not always satisfactory.

In this sense, the intervention for this psychopathology usually includes both psychotherapy and pharmacological treatment.

Pharmacotherapy

The pharmacological treatment of depressive neurosis is subject to some controversy. Thus, no drug is capable of completely reversing the alteration.

However, selective serotonin reuptake inhibitors (SSRIs) are the most effective antidepressants and, therefore, the pharmacological treatment of choice.

The most commonly used drugs are fluoxetine, paroxetine, sertraline, and fluvoxamine.

However, the action of these drugs is slow, and the effects do not usually appear until 6–8 weeks after treatment. In turn, the efficacy of antidepressant drugs has limitations in treating depressive neurosis.

Several studies show that the efficacy of these drugs would be less than 60%, while the placebo would reach 30% efficacy.